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Emergencies in ambulatory care usually require only basic interventions
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The most commonly occurring emergency in the pediatric ambulatory care setting is respiratory distress, but most events are resolved with basic interventions such as albuterol or oxygen, according to research published in Pediatrics.
“The management of pediatric emergencies in an ambulatory care setting can be challenging because they are rare events requiring specialized skills that need to be performed in a time-sensitive manner,” Matthew L. Yuknis, MD, assistant professor of clinical pediatrics at the Indiana University School of Medicine, and colleagues wrote. “Few data exist regarding the frequency and etiology of these events for providers to use, likely because of their infrequent nature and lack of a widely accepted definition for emergency in an ambulatory care setting.”
Yuknis and colleagues assessed the frequency of pediatric emergencies in ambulatory practices requiring emergency medical services (EMS) in the greater Indianapolis metropolitan area. They also characterized the types of illnesses that required EMS and the interventions patients needed during their transport from an office setting to the hospital setting.
The researchers identified 38,841 pediatric emergencies that required EMS transportation between Jan. 1, 2012, and Dec. 31, 2014. Nearly 350 (0.85%) of these events occurred in ambulatory practices — a rate of 42 emergencies per 100,000 children annually.
Most emergencies occurring in ambulatory settings were respiratory distress (58.1%), psychiatric or behavioral emergencies (6.3%) and seizures (6.3%). Supplemental oxygen was used in 27.4% of emergencies, and albuterol was used in 26.5%. Other critical care interventions were rarely needed.
Emergencies and EMS encounters in ambulatory care were most commonly reported in townships of lower socioeconomic status.
“The results of this study have broad implications regarding ambulatory practice emergency readiness, planning and equipment and medication availability,” Yuknis and colleagues wrote. “There are also potential implications regarding the ongoing education of pediatric providers, especially regarding psychiatric and behavioral emergencies. Further studies in other urban and/or suburban locations, as well as rural settings, would help with this study’s limitations, having been done in a single urban and/or suburban location.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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